Susan Greenspan, M.D., Professor of Medicine at University of Pittsburgh, is applying for the K24 Midcareer Investigator Award in Patient-Oriented Research to advance her career in clinical investigations of osteoporosis in older men and women. Her immediate career objectives are 1) to establish herself as a leading national authority on osteoporosis in the elderly with a new focus on older men, and 2) to serve as a mentor for medical trainees, including medical students, fellows, and junior faculty members pursuing patient-oriented research in osteoporosis and related geriatric fields. Her long-term objectives are 1) to apply the expertise and skills in patient-oriented osteoporosis research to clinical research in other fields involving common endocrine or geriatric syndromes, and 2) to actively participate in the institutional commitment to promote clinical research at the University of Pittsburgh through mentoring and teaching activities. Dr. Greenspan's research will center on two areas. First, she will explore novel treatments with combination therapy with antiresorptive and anabolic agents for postmenopausal osteoporosis. New techniques assessing outcomes of trabecular vs. cortical bone density and markers of bone turnover will be utilized. Secondly, a model of male osteoporosis will be examined-that of bone loss following androgen deprivation therapy in men with prostate cancer. She will examine the pathophysiology of this bone loss and its prevention. Dr. Greenspan has a strong track record in mentoring junior investigators. This award would ensure protected time for mentoring activities that provide appropriate direction, resources, and educational programs for her trainees. Furthermore, this proposal will allow protected time for the candidate's self education for additional training in statistical analysis, the essentials of mentoring, involvement of African American subjects in clinical research, and leadership in academic medicine for women. The clinical research and mentoring program will be conducted at the University of Pittsburgh, which has a strong institutional commitment to the professional development of the candidate and a mission to support patient-oriented activities of its faculty members. The General Clinical Research Center (Dr. Greenspan's clinical laboratory), the Center for Minority Health, and the recently funded Clinical Research Training Award (K30) will help facilitate this proposal.